Hip OA Part II

Hip OA Part II

Examination-Classification


According to the American College of Rheumatology patients can be classified as having hip OA if they present with pain and either of the following cluster findings:

 -Hip IR less than 15 degrees, with pain
 -Hip flexion of less than 115 degrees
 -age greater then 50

OR

 -Hip IR less than 15 degrees, with pain
 -Duration of morning stiffness less than or equal to 60 minutes
 -age greater then 50
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Sensitivity of 86%: Specificity of 75% when compared to radiographs
The following Tests should be utilized during examination FOR DIFFERENTAIL DIAGNOSIS:

-Scour test for labral tears
-FABER (Patrick’s) Test for labral tears
-Fitzgerald’s test for labral tears
-Flexion-adduction internal rotation test for labral tears
-Sacroiliac joint provocation testing for SI joint pain
-Femoral nerve stretch for L2-3 radiculopathy

Outcome Measures


-WOMAC
-LEFS
-Harris Hip Score


-Treatment

-Anti-inflammatory provide temporary relief

-Glucosamine studies indicate mix results with some indicating short-term improvement but most studies indicate minimal to non-existent short term to long term benefits

-Injections- Research indicates they may provide short term relief.

Patient education- Self management techniques have been effective in improving function, reducing stiffness, fatigue, and medical usage


Exercises:  ROM and strengthening have been advocated and been deemed affective by multiple research articles.  3 categories of exercise include:

 -ROM/Flexibility
 -Muscle strengthening
 -Aerobic conditioning